Patient Outcomes Suffer When the ED Is Crowded

A well-controlled study in Canada shows higher risk for mortality and hospital admission with longer emergency department length of stay.

Numerous studies have examined the associations between emergency department (ED) crowding, medical errors, and patient outcomes, but persuasive evidence of a causal association with “hard outcomes” — such as mortality — is lacking. Researchers analyzed data for 20.4 million ED visits in Ontario, Canada, between 2003 and 2008 to determine whether rates of mortality and hospital admission within 7 days after leaving the ED differed with level of ED crowding (calculated as average length of stay during the 8-hour shift in which a patient presented). To avoid confounding by hospital crowding, the researchers focused on the 17.8 million patients (87%) who were discharged from the ED or left without being seen.

In controlled multivariable analyse…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education